Panic Disorder Treatments – What You Should Know
This article will provide a brief overview of the
contents of the American Psychiatric Association’s (APA) Treatment of
Patients with Panic Disorder, in an effort to help you understand how your
mental health professional is most likely to approach your care and
treatment.
The information
contained herein is summarized in an effort to be understood by laymen, not
clinicians, and much of the information has been paraphrased to help you
understand it. The APA first
published the guideline in 1998, and has been updated as recently as January
2009 on the APA’s website. It
was developed by a work group, rather than a single psychiatrist, and
continues to be the most widely used guidance for doctors, which is why
understanding what it says is important for anyone who suffers from panic
disorder and wants to know more about panic disorder treatments.
Involving All Your Care-Givers
The guidelines first lay out for your psychiatrist that you will be anxious about treatment, as that is part and parcel of the condition, and goes on to recommend that all your doctors be kept up-to-date on your treatment. The guidance further encourages your doctor to let you know what to do when you feel like an attack is an emergency, whether it is providing a pager number for them, going to the emergency department, or even calling 9-1-1.
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Psychiatric Assessments
Your doctor is instructed to put you through a complete assessment or examination to make sure that panic disorder is really what you have and to also rule out any medical conditions that might be causing panic attacks, but that do not qualify as panic disorder. (For more information on what types of questions you may be asked during this assessment, please refer to the article on this site titled, Panic Attack Treatment for Chronic Sufferers – What Your Doctor Will Ask, or visit the APA’s website and review a separate guideline called, Practice Guideline for the Psychiatric Evaluation of Adults, Second Edition.)
Making a Treatment Plan Just For You
The next step for your psychiatrist will be to develop a plan that fits your individual needs. He or she should work closely with you to do this by figuring out, with your help, how often you have attacks, how your attacks manifest themselves (that is, what sort of things do you feel, see, and hear while you are having an attack), and what degree of other phobias (like agoraphobia) you experience. Your doctor may ask you if you keep a daily journal or diary, and if you do not already, will probably recommend that you start one. Your plan will also include recommendations for treating any other medical conditions or illnesses that you have aside from panic disorder.
Sometimes your doctor will tell you that you must have a co-morbidity, which is another condition that you have in addition to panic disorder, treated first, before he or she can begin to treat your panic disorder. If this is the recommendation, you may be instructed to see your regular family care or internal medicine doctor. Both of your physicians should keep in contact with one another during this process.
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Making Sure You are Safe
Your doctor has an obligation to make sure that your panic disorder will not put you in danger. That means he or she will carefully evaluate whether you are at risk of suicidal thoughts or feelings, or if your particular condition makes you more prone to act out in violent ways towards others. If your psychiatrist determines that you could potentially pose a risk to yourself or others, be aware that outpatient treatment may not be the first choice, and inpatient treatment may be ordered. If it is, and you agree, then check yourself in for treatment. If you don’t agree, however, it is perfectly acceptable to get a second opinion, but if the second doctor agrees with the first, it will be in your best interest to get the help you need, no matter what you have to do.
Figuring Out What You Can and Cannot Do
The guidelines instruct your doctor to determine your level of functional impairment. That means he or she will want to know if you suffer from agoraphobia and are afraid to leave your home, or if your condition prevents you from doing things that you should be able to do, such as drive a car. Even after you have started and participated in treatment for awhile, these impairments can stay with you, and it will be up to your doctor to help you overcome them.
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Treatment Goals
The main focus of your panic attack treatment will be to reduce your attacks, obviously, but your treatment goals will also include intermediate and long-term goals. This means that if you are going to be put on medication, the treatment goals should speak to when you can expect to be taken off the medication, or when your dosage can be stepped-down or lowered. The treatment goals should also include how any other illnesses for which you are being treated should be responding in conjunction with your treatment for panic disorder.
Keeping Track of Your Progress
The psychiatrist, through the guidelines, is instructed to continue to monitor your progress, not only for the conditions you start off being treated for, but for any others that may crop up during your treatment. That means that maybe your panic attacks are starting to subside, but that you are having more and more inclinations of agoraphobia or another phobia. The doctor must pay attention to all these things at the same time and will want to see you frequently to see how you’re doing.
Keeping You in the Loop
Finally, it is important that your clinician keeps you up to speed on what is happening with your treatment, and fully explains every part of your panic disorder treatment at every step of the way. If your doctor does not seem to share enough information with you, you should ask for more information, and do not be afraid to point out that the APA’s guidelines instruct he or she to keep you in the loop about your panic disorder treatment.
